Passmed Knowledge Flashcards
Asymptomatic patients wiith impaired glucose or Hba1c require what
Another measurement
What Heam Conditions can give a flase low Hba1C
Sickle Cell Anaemia
Hereditary Spherocytosis
G6PD Deficiency
Beta Thallasaemia
What Haem Conditions can give a false high HbA1C
Splenectomy
B12/Folate Deficiency
Iron Deficiency Anaemia
Target HBA1C in T2DM
When would this change and to what?
<48
<53 in those with a second agent added or in hypoglycaemic drugs
Marker for MODY and management?
HNF1 Alpha
Sulfonylurea (Gliclazide)
1st and 2nd line investigations for acromegaly
Serum IGF 1
OGTT and growth hormone levels to confirm
Side Effects of Levothyroxine Therapy
hyperthyroidism: due to over treatment
reduced bone mineral density
worsening of angina
atrial fibrillation
Unilateral Adrenal Hyperplasia management?
Adrenalectomy
Bilateral Adrenal Hyperplasia Management?
Spironolactone
Diabetes Reference Ranges
Fasting Glucose
OGTT
HBA1C
Fasting: >7
OGTT or Random GLucose: >11.1
HBA1C: >48
Management of Thyrotoxic Storm
B-Blockers
Propylthiouracil
Hydrocortisone
Diagnostic Criteria for HHS
Hypovolaemia
Hyperglycaemia
Serum osmolality >320
What are the T1DM autoantibodies
Anti-GAD
ICA
IAA
IA-2A
Management of Myxoedemic Coma
IV thyroxine and Hydrocortisone
When PTH is high then what is Low
Phosphate
Hashimotos Thyroiditis Triad
Hypothyroidisim + Goitre + Anti-TPO
What is whipples triad?
What is it used to diagnose
Hypoglycaemia symptoms
BM < 2.5
Reversal of symptoms with glucose
Insulinoma
DVLA requirements for Surrendering drivers licence?
Two episodes of hypoglycaemia in 12 months
Management of hypercalcaemia
Iv Saline
if Ca >3 then IV bisphosphonates
Long term management of post menopausal woman with a fracture
Immediately bisphosphonates and Ca supplements
Blood Pressure Medication of Choice in T2DM Patients
Does this change if they are afro carribean and what to?
Ace Inhibitor
Yes to an ARB
How is subclinical hypothyroid managed and what are the parameters for starting treatment
Managed with levothyroxine
<65 with symptoms
OR
TSH >10 regardless of age
Otherwise watch and wait and repeat TFT’s in 6 months
What causes impaired awareness of hypoglycaemia in T1DM
Neuropathy of the ANS
How to differentiate between pituitary tumour and ectopic tumours in cushings and what is the result
CRH test
Pituitary tumour will respond, Ectopic will not
Low/High Steroid Effects on BM
Low Steroids can cause Hypoglycaemia
high Steroids can cause hyperglycaemia
Iodine uptake in graves?
Increased homogenous uptake
Important side effect of carbimazole
Agranulocytosis
Iodine uptake in toxic multinodular goitre?
Patchy
Mechanism of Action for Orlistat?
Pancreatic Lipase Inhibitor
Values for
Impaired Fasting Glucose
Impaired Glucose Tolerance
Impaired Fasting: >6.1
Impaired Glucose Tolerance: > 7.8
Metastatic Malignancy can cause addisons yes or no
YES
Iodine Uptake in Dequervains (Subacute) Thyroiditis
Globally Reduced
Inheritance pattern of MODY?
Autosomal Dominant
What effect do thiazide diuretics have on calcium levels
Hypercalcaemia
How is serum osmolality calculated
2 x NA + Glucose + Urea
Patients with BPPH cannot be given which neuropathic painkiller?
Amitryptiline
Name 4 drugs that cause gynaecomastia
Ranitidine Digoxin Spironolactone Isoniazide Goserelin
Name 4 drugs that can cause galactorrhoea?
Metoclopramide
Chlorpromazine
Haloperidol
Domperidone
What kind of heart defect is assoc with acromegaly?
Cardiomyopathy
